Emergencies Optometrists See ALL The Time (And What We Do About It!)

Optometrists are first line providers for urgent eye issues and can diagnose and treat many eye conditions. Optometrists can also provide emergency referrals to ophthalmologists for more complex conditions and eye surgeries.

Today’s blog will delve into common eye emergencies I see all the time, and the many different ways they can be treated.

1)    Red Eyes

I see patients for sore, red eyes almost every day. Red eyes are EXTREMELY difficult to diagnose by someone who isn’t an eye doctor because on the surface, they tend to look very similar. Some of the causes of “red eye” I commonly encounter are:

- Conjunctivitis (“Pink Eye”): This very general term is often used to describe viral, bacterial, allergic or even fungal infections. All these conditions are treated in totally different ways.

- Eye Inflammation: A common eye inflammation I encounter is called uveitis. This very painful condition is treated with high dose steroids and dilating drops.

- Acute Glaucoma: Acute glaucoma requires aggressive medication or surgery to lower the eye pressure back to normal levels and needs to be treated right away to avoid blindness.

- Herpetic Infections: Ocular herpes (including shingles) can be treated with antivirals.  

- Dry Eye: Redness related to dry eye can often be managed with artificial tears.

- Corneal Ulcers: Corneal ulcers, which I most commonly see in contact lens wearers, are treated with strong topical antibiotics. Corneal ulcers in contact lens wearers will typically develop due to over-wearing the lenses, sleeping in them, or not taking care of them.

Notably, all these eye conditions have COMPLETELY different ways of treating them, even though they may look pretty much the same to someone who’s not an eye doctor. If your red eye isn’t diagnosed and treated properly, it could have the potential to cause permanent eye damage and vision loss. This is why if you have a red eye, it is so important to have it looked at by an eye doctor. Optometrists and ophthalmologists have the equipment for proper diagnosis and specialized training to detect the subtle differences between different types of red eye.

2)    Foreign Objects In The Eye

The cornea is extremely sensitive and even getting something in it as simple as an eyelash can be very irritating. So, I’m sure you can imagine how painful it must be to get a piece of metal in the eye. Optometrists can safely remove foreign bodies from the eye using special equipment. Having foreign objects removed right away is important, because these objects can sometimes cause permanent scarring. Some objects I’ve removed from the eyes include metal, confetti, hair, dirt, and even a grasshopper!

3)    Lid Swelling

Common causes of lid swelling I encounter are styes, which are bacterial infections in the glands of the eyelids, and allergic reactions like contact dermatitis. However, it’s very important to have any lid swelling examined because it can sometimes be a mark of a more sinister underlying condition. For example, preseptal cellulitis is an infection in the soft tissue around the eyelids and needs to be treated with aggressive oral antibiotics to prevent it from potentially spreading to the brain.

4)    Flashes and Floaters

Whenever you experience new flashes and floaters in the eye, you need to have your eyes looked at as soon as possible. Flashes and floaters can be a symptom of a retinal hole, tear, or detachment. These conditions can potentially cause permanent vision loss if not identified and treated immediately. Optometrists can diagnose these conditions and refer you for emergency surgery with an ophthalmologist if necessary. If the flashes and floaters are unrelated to a serious condition, optometrists will monitor your eyes in their clinic. A posterior vitreous detachment, for example, is a very common cause of floaters that your optometrist can monitor in their clinic.

5)    Sudden Onset Vision Loss

Sudden onset vision loss is an emergency! It can indicate conditions like a retinal detachment or even a stroke within the eye. The optometrist’s office is a good place to start to diagnose the cause of the vision loss and refer urgently if necessary. However, going to the emergency room is a very valid option if your optometrist’s clinic is closed because there is often an ophthalmologist on-call.

6)    Sudden Onset Double Vision

Sometimes double vision can be a result of changes in eye muscle strength with age, but if it happens all of a sudden, it is important you have your eyes examined right away with your optometrist, ophthalmologist, or at the ER.

7)    Eye Injuries

Toddler poked you in the eyeball? Walked into a tree branch when out for a hike? Eye injuries can be really painful, but your optometrist can help. In the case of a chemical in the eye, it's important to flush the eyes with water for at least 20 minutes, then seek emergency medical care.

Having sudden changes to your eyes can be scary, but your optometrist can help figure out what’s going on and direct you to the proper treatment to help you feel better.  Many optometrists hold appointment slots in their schedule for eye emergencies so if you think you are experiencing an ocular emergency, give your optometrist a call, today!

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